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STEP 1 (4) > Mycology > Flashcards

Mycology Flashcards

(48 cards)

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1
Q

What fungi can cause systemic mycoses?

A

Histoplasmosis

Blastomycosis

Coccidioidomycosis

Paracoccidioidomycosis

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2
Q

Notes about the systemic mycoses inducing fungi

A
  • All can cause pneumonia and can disseminate
  • All are dimorphic fungi (cold (20C)= mold; heat (37C)= yeast)- the only exception is coccoidomycosis, which is a spherule (not yeast) in tissue

Tx with fluconazole or itra for local infection and ampho B for systemic

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3
Q

Systemic mycoses can mimic TB (granuloma formation) but…

A

they have no person-person transmission

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4
Q

What is this?

A

Histoplasmosis (histo bodies within macrophages)- associated with brid or bat droppings

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5
Q

Where is Histoplasmosis endemic?

A

Mississippi and Ohio River Valleys- causes pneumonia

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6
Q

Blastomycosis-broad-based buding (same size as RBCs)

A

Blastomycosis- causes inflammatory lung disease and can disseminate to skin and bone (forms granulomatous nodules)

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7
Q

Blastomycosis- common in states east of the Mississippi River and Central America

A
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8
Q

Coccidioidomycosis- spherules (much larger than RBCs)- filled with endospores

A

Coccidioidomycosis

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9
Q

Where is Coccidioidomycosis common?

A

Southwestern US, California- causes meningitis and penumonia and can disseminate to bone and skin

Common after earthquakes when spores are thrown into the air and inhaled to form spherules

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10
Q

Paracoccidioidoycosis- budding yeast with ‘captains wheel’ formation

A

Paracoccidioidoycosis-common in Latin America

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11
Q

What are the major cutaneous mycoses?

A

TInea (dermatophytes)- capitis, corporis, cruris, pedis, unguium

Tinea versicolor

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12
Q

Dermatophytes (tinea) include what spp?

A

Microsporum

Trichophyton

Epidermophyton

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13
Q

How is Tinea diagnosed?

A

branching septate hyphae visible on KOH prep with blue fungal stain

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14
Q

How does tinea capitis present?

A

Occurs on head, scalp, and is associated with LD< alopcia, and scaling

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15
Q

How does tinea corporis present?

A

Occurs on the body and is marked by erythematous scaling rings (ringworm) and central clearing- can be acquired from contact with an infected dog or cat

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16
Q

How does tinea cruris present?

A

Occurs in inguinal area and often DOES NOT show the central clearing seen in tinea corporis

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17
Q

Describe tinea pedia

A

3 varieties:

Interdigital (most common) (below)

Moccasin distribution

Vesicular types

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18
Q

Tinea pedis- Vesicular type

A

Tinea pedis- Moccasin type

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19
Q

Describe Tinea unguium

A

Onchomycosis; occurs on nails

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20
Q

What causes Tinea versicolor?

Study These Flashcards
A

Malassezia spp (Pityrosporum spp.), a yeast-like fungus (not a dermatophyte despite being called tinea)

NOTE: Below: degradation of lipids produces acids that daage melanocytes and cause hypopigmentation and/or pink patches

21
Q

When is Tinea versicolor most common?

Study These Flashcards
A

summer (hot, humid weather)

22
Q

What does Tinea versicolor look like on microscopy?

Study These Flashcards
A

Spaghetti and meatballs

23
Q

What are the main opportunistic fungal infections?

Study These Flashcards
A

Candida albicans

Aspergillus fumigatus

Crytpococcus neoformans

Mucor and Rhizopus spp.

24
Q

What is this?

Study These Flashcards
A

Candida albicans- pseudohyphae and budding yeasts at 20C and germ tubes at 37C

25
Candida can cause oral and esophageal thrush in immunocompromised (neonates, steroids, diabetes, AIDs), vulvoganitis (diabets, ABX users), diaper rash, endocarditis in IVDU, disseminated candidiasis
Candida vulvovaginitis
26
How is Candida tx?
topical axzole for vaginal nystatin, fluconazole, or caspofungin for oral/esophagel fluconazole, caspofungin, or ampho B for systemic
27
Aspergillus fumigatus- invasive aspergillosis, especially in immunocompromised and those with chronic granulomatous disease Diagnosis: Septate hyphae that branch at 45 degrees (ACUTE!!)
NOT dimorphic
28
What diseases does Aspergillus fumigatus cause?
Alergic bronchopulmonary aspergillosis (ABPA)- associated with asthma and cystic fibrosis; may cause bronchiectasis and eosinophilia Aspergillomas in lung cavities, especially after TB infection
29
Some species of Aspergillus produce \_\_\_\_\_\_\_
alfatoxins, which are associated with hepatocellular carcinoma
30
What is this?
Cryptococcus neoformans, the cause of cryptococcosis
31
What is the structure of Cryptococcus neoformans?
heavily encapsulated yeast (not dimorphic)
32
What is the major association of Cryptococcus neoformans?
soil and pigeon droppings (acquired through inhalation with heme dissemination to meninges)
33
How is Cryptococcus neoformans confirmed?
India Ink or **mucicarmine** stain culture on Saboruaud agar Latex agglutination test detects polysaccharide capsular antigen and is more specific
34
Crypto- soap bubble lesion in brains
Crypto- soap bubble lesion in brains
35
What fungal disease is most common in ketoacidotic diabetics and/or neutropenic pts (e.g. leukemia)?
Mucormycosis
36
Mucomycosis- look for rhinocerebeal, frontal lobe abscesses, or cavernous sinus thrombosis HA, facial pain, and black necrotic eschars on face common
**Wide angle branching hyphae!!**
37
How is Mucormycosis tx?
surgical debridement and ampho B
38
What is the cause of Pneumocystis pneumonia (PCP)?
Pneumocystis jirovecii
39
Describe Pneumocystis jirovecii
This is a yeast like fungus that is inhaled and most infections are asymptomatic and immunosuppression predisposes to disease.
40
How does PCP present?
diffuse, bilateral ground-glass opacitices on CXR/CT
41
Opacities seen with PCP- look near the back of each lung
42
How is PCP diagnosed?
lung lavage or lung biopsy
43
How does Pneumocystis jirovecii appear on methanmine silver stain of lung tissue?
Disc-dhaped yeast form
44
How is PCP tx?
TMP-SMX, pentamidine, dapsone (prophylaxis only), atovaquone (prophylaxis only)- make sure to start prophylaxis when CD4+ count drops below 200/MM3 in HIV pts.
45
What is this?
Sporotrichosis (sporothrix schenckii)
46
Describe Sporothrix schenckii
dimorphic, cigar-shaped budding yeast that lives on vegetation
47
How is Sporothrix schenckii transmitted?
When spores are traumatically introduced into the skin, typically by a thorn (rose gardener' disease), it causes a local pustule or ulcer with nodules along draining lymphatics (asending lymphangitis) Disseminated disease possible in immunocompromised hosts
48
How is Sporothrix schenckii tx?
itra or posassium iodidi

STEP 1 (4) (18 decks)

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